Private health patients are costing public millions
The study showing blurred boundaries is the first of its kind for New Zealand
Private health patients are costing New Zealand’s public system up to $11.5 million a year, a new study shows. Taxpayers are footing the massive annual bill — which equates to the cost of 760 hip replacements — for patients who need public hospital care after private inpatient treatment, the University of Otago study published in the international journal Health Policy reveals.
The study used 2013/2014 data from the Ministry of Health and examined the frequency of public hospital admissions within seven days of a patient receiving privately funded healthcare.
Lead author Dr Erin Penno, of the department of Preventive and Social Medicine and Centre for Health Systems, says about 2 per cent of private inpatient events had a subsequent admission to a public hospital.
“That’s the equivalent of 1800 patients moving from the private to the public healthcare system,” Penno said.
“We might expect the cost of private hospital care be borne entirely privately, but our study suggests that is not always the case.
“Millions of dollars of public money is being spent on providing acute follow-up care for patients who have received care privately.”
According to the health and disability system review, about 5 per cent of health spending in New Zealand comes from private health insurance and about 14 per cent from out of pocket. Just over a third of New Zealanders hold private health insurance.
“While we should provide healthcare to those who need it, our study highlights that the financial boundaries between the private and public health sectors are blurred,” Penno said.
“Our findings also suggest there is a risk that increasing use of the private sector may put more pressure on stretched public hospitals, crowding out those less able to afford private care and, in effect, increasing existing inequities in access and outcomes of care.”
The study is the first of its kind for New Zealand. Until relatively recently, no data has been available to
Millions of dollars of public money is being spent on providing acute follow-up care for patients who have received care privately. Dr Erin Penno
be able to look at private sector activity and the flow of patients between the private and public health systems. However, in recent years, the number of private hospitals submitting data to the Ministry of Health has increased substantially, which Penno said they used to evaluate whether cost-shifting from the private to public health systems was a significant issue in New Zealand.
“The private sector has argued that privately funded care comes at no cost to taxpayers and enables the public sector to focus limited resources on those most in need,” Penno said.
“This analysis challenges that preconception, highlighting the small but significant flow of costs from the private to public health sectors and further illustrating the blurred boundaries between public and private provision in New Zealand.”
The most common reason for patients seeking public healthcare after a private healthcare treatment was after elective procedures such as hip and knee replacements, for haemorrhage, infection and disorders of the circulatory and digestive system.
Penno stressed, however, that it was important to acknowledge that some readmissions are unavoidable, with international evidence suggesting up to a third are preventable.
“Evidence suggests that improving discharge planning, care coordination and supporting patient self-management can reduce hospital readmissions. Using data to provide a clearer picture of readmission events would support this,” she said.
“We should be capitalising on joined-up data across the private and public health sectors to improve visibility to district health boards and private providers around the extent and potentially the drivers of readmissions.”
Missed intelligence was to blame for the outmanned Capitol defenders’ failure to anticipate the violent mob that invaded the iconic building and halted certification of the presidential election on January 6, the officials who were in charge of security that day said yesterday in their first public testimony on the insurrection.
The officials, including the former chief of the Capitol Police, pointed their fingers at various federal agencies — and each other — for their failure to defend the building as supporters of then-President Donald Trump overwhelmed security barriers, broke windows and doors and sent lawmakers fleeing from the House and Senate chambers. Five people died as a result of the riot, including a Capitol Police officer and a woman who was shot as she tried to enter the House chamber with lawmakers still inside.
Former Capitol Police chief Steven Sund, who resigned under pressure immediately after the attack, and the other officials said they had expected the protests to be similar to two pro-Trump events in late 2020 that were far less violent. Sund said he hadn’t seen an FBI field office report that warned of potential violence citing online posts about a “war”.
Sund described a scene as the mob arrived at the perimeter that was “like nothing” he had seen in his 30 years of policing and argued that the insurrection was not the result of poor planning by Capitol Police but of failures across the board.
“No single civilian law enforcement agency – and certainly not the USCP – is trained and equipped to repel, without significant military or other law enforcement assistance, an insurrection of thousands of armed, violent, and co-ordinated individuals focused on breaching a building at all costs,” he testified. The hearing was the first of many examinations of what happened that day, coming almost seven weeks after the attack and over a week after a Senate minority acquitted Trump of inciting the insurrection by telling his supporters to “fight like hell” to overturn his election defeat.
Fencing and National Guard troops still surround the Capitol in a wide perimeter, cutting off streets and sidewalks that are normally full of cars, pedestrians and tourists.
The joint hearing, part of an investigation by two Senate committees, was the first time the officials testified publicly about the events of January 6.
In addition to Sund, former Senate sergeant-at-arms Michael Stenger, former House sergeant-at-arms Paul Irving and Robert Contee, the acting chief of police for the Metropolitan Police Department, testified.
Irving and Stenger also resigned under pressure immediately after the deadly attack. They were Sund’s supervisors and in charge of security for the House and Senate.
“We must have the facts, and the answers are in this room,” Senate rules committee chairwoman Amy Klobuchar said at the beginning of the hearing. The rules panel is conducting the joint probe with the Senate homeland security and governmental affairs committee.
Even after the hearing, much still remains unknown about what happened before and during the assault.
How much did law enforcement agencies know about plans for violence that day, many of which were public?
And how could the Capitol Police have been so ill-prepared for a violent insurrection that was organised online?
Fuelled by black turnout, Democrats scored stunning wins in Georgia in the presidential and US Senate races. Now, Republicans are trying to make sure it doesn’t happen again.
Republican lawmakers in the once reliably red state are rolling out an aggressive slate of voting legislation that critics argue is tailored to curtail the power of black voters and undo years of work by Stacey Abrams and others to increase engagement among people of colour, including Latino and Asian American communities.
The proposals are similar to those pushed by Republicans in other battleground states: adding barriers to mail-in and early voting, major factors in helping Joe Biden win Georgia’s 16 Electoral College votes and Raphael Warnock and Jon Ossoff take the two Senate seats that gave Democrats control of the chamber.
But one aspect of their plans, a proposal to eliminate early voting on Sundays, seems specifically targeted at a traditional get-out-the-vote campaign used by black churches, referred to as “souls to the polls”. It’s led many to suggest Republicans are trying to stop a successful effort to boost black voter turnout in Georgia, where they make up about a third of the population and have faced a dark history of attempts to silence their voices in elections.
“It’s a new form of voter suppression, the Klan in three-piece suits rather than white hoods,” said the Reverend Timothy McDonald III of the First Iconium Baptist Church in Atlanta, which has participated in souls to the polls events. “They know the power of the black vote, and their goal is to suppress that power.”
In Georgia and elsewhere, Republicans say proposals to tighten voting access are meant to bolster confidence in elections, though they have been some of the loudest proponents of meritless claims that the election was fraudulent. The Brennan Centre for Justice, a public policy group, has counted 165 bills in 33 states this year meant to limit access to voting.
In Georgia, Republicans control state government and have introduced dozens of legislative measures that would restrict voting access. GOP state Representative Barry Fleming is chief sponsor of a wide-ranging proposal that would ban Sunday early voting, require a photo ID for absentee voting, limit the time when an absentee ballot could be requested, restrict where ballot drop boxes could be placed and curb the use of mobile voting units, among other changes.
Nse Ufot, CEO of the New Georgia Project that Abrams founded in 2014, called the GOP measures a backlash “to our multiracial, multilingual progressive majority that is winning elections”.
Biden beat former President Donald Trump by roughly 12,000 votes, becoming the first Democrat to win a presidential contest in Georgia since 1992. Biden received nearly double the number of absentee votes as Trump in a state that became a major target of Trump’s baseless claims of fraud. Biden’s win there was confirmed in three separate counts, including one by hand.
“These measures, in our opinion, are not based on any objective, datadriven, evidence-based assessment of the issue but solely with the intention to undermine black voters and other communities of concern,” said Democratic state Representative Michael Smith, chairman of the Georgia Legislative Black Caucus Policy Committee.
Because Republicans control both chambers of the legislature and the governor’s office, at least some form of their proposals are likely to become law.